How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | None | $363.08 | $363.08 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,174.90 | $4,265.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $831.76 | Professional | None | $371.54 | $436.52 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | None | $398.11 | $630.96 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $10,471.29 Typical High $29,512.09 | Facility | None | $5,623.41 | $10,471.29 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $660.69 | Professional | None | $407.38 | $446.68 | $660.69 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $562.34 | Professional | None | $295.12 | $354.81 | $562.34 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $288.40 |
Where New Jersey sits
The same service costs 7.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Jersey· 38th of 51
$417
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.